Recently Viewed

Sisters of Mercy Health System

As part of an organization-wide effort to reduce medication
errors and improve patient outcomes, Mercy formed the 'Mercy Meds'
program. The program was designed to enable Mercy to distribute all
of its medical and pharmaceutical supplies from a single
Consolidated Services Center based in Springfield, Mo., resulting in
streamlined workflow, increased productivity and a reduction in
medication errors.

The Challenge

Like other healthcare organizations, Sisters of Mercy Health
System (Mercy) was concerned by the results of the 1999 study
published by the Institute of Medicine, "To Err is Human,"
which cited medication errors as the eighth leading cause of death
in the United States. Administrators at St. Louis-based Mercy, the
ninth largest not-for-profit healthcare system in the nation,
suspected that any medication errors its hospitals experienced were
less attributable to human error and instead more likely the result
of inadequate internal processes.

Mercy decided to take a leadership role in reducing medication
errors within its facilities. "We needed a way to help ensure
that the right patient receives the right medication in the right
dose at the right time," says Curtis Dudley, executive director
of optimization management for Resource Optimization &
Innovation (ROi), Mercy's supply chain operating division. "We
believed most medication errors could be avoided by centralizing
supply chain operations and implementing technology-based solutions
such as bar coding."

In response, representatives from a number of functional areas
within Mercy, including nursing, the pharmacy, supply chain
operations and IT, put their heads together to develop a more
effective way to track medications throughout the supply chain—from
the warehouse to the hospital pharmacy, nursing floors and,
eventually, the patient.

Additionally, because pharmacists had to spend so much of their
time checking that the correct medications were pulled from the
pharmacy shelf, they had limited time to interact with physicians
and patients. Mercy hoped that standardizing the pharmaceutical
shipment process would enable its pharmacists to spend more time
utilizing their expertise for patient care and less time on
administrative tasks.

The Solution

In 2001, as part of an organization-wide effort to reduce
medication errors and improve patient outcomes, Mercy formed the
Mercy Meds program, an innovative supply chain-driven, clinical
patient safety initiative that serves Mercy's 20 hospitals located
throughout Oklahoma, Kansas, Missouri and Arkansas. The program was
designed to enable Mercy to distribute all of its medical and
pharmaceutical supplies from a single Consolidated Services Center
based in Springfield,Mo., resulting in streamlined workflow,
increased productivity and a reduction in medication errors.

After carefully considering the technology needs for Mercy Meds,
Mercy chose printers from Zebra Technologies to produce its barcode
labels. Mercy had previously used Zebra® printers in its supply
chain operations and found them to be durable and easy to use. The
organization deployed Zebra's Z4M™ and TLP 3844-Z™ printers in its
main distribution facility to generate shelf, unit-dose medication
and tote labels, and in all of its receiving docks to produce
ship-ment tracking labels. The TLP 3844-Z printer accommodates a
variety of label sizes and is used to create barcode labels for
products that the manufacturer has not barcoded or to replace
barcodes that won't scan.

"Since our program is centered on patient safety, it was
critical that we selected high-quality, reliable printers that would
produce clear barcodes with a high scan rate," says Dudley.
"Our Zebra printers have proven to be workhorses—generating
thousands of labels each day while consistently producing crisp and
highly scannable labels and requiring only minimal maintenance."

When medications arrive at the service center, staff repackages
the tablets or capsules into unit doses and then applies barcoded
labels to the unit dose packages. If someone in the local hospital
pharmacy scans the barcode label on a shelf that is low on inventory
for a specific medication, a replenishment order for that medication
is triggered. The automated medication cabinets on the nursing floor
also generate a replenishment request when inventory reaches a
pre-determined minimum.

Once the replenishment order is received in the service center,
a barcoded tote label containing the order fulfillment information
is generated. A materials handler scans the tote label and pulls the
required unit dose packages off the shelf and packs them in the tote
bound for the hospital. A barcoded tracking label is applied to the
tote, enabling the order to be tracked from the distribution center
to the hospital site. "When the hospital receives the tote, the
medica-tions can go from the delivery truck to the medication
cabinets on the patient floors without stopping in between, which is
a huge time-saver," says Doreen Northrup, manager of pharmacy
services at Mercy.

Results

Whereas Mercy's pharmacists once spent a great deal of time
verifying medications, they can now devote more time to patient
care. They are able to consult with physicians and clinicians and
help them choose the best medication for the patient. For example,
the pharmacist may recommend treating a condition with an oral dose
instead of an IV solution or medication, which may reduce costs and
lead to a better patient outcome. "We've equipped our
clinicians with a process that ensures they are delivering quality
care in a very safe manner to patients," says Gene Kirster, COO
of ROi.

Mercy Meds has also enabled Mercy to ensure that the right
patient gets the right medication in the right dose at the right
time—a key objective of the program. "We estimate that we have
averted more than 17,000 potential medication errors
annually—equivalent to a savings of approximately $14 million per
year on litigation and treatment costs," says Kirster.

The ability to automatically replenish inventory and reduce the
amount of expired products are also strong benefits for Mercy.
"We are able to manage inventory more strategically across the
organization and keep products in locations where there is the
greatest need," says John Black, vice president of supply chain
for ROi. Additionally, in the case of a product recall, staff can
quickly locate and pull the recalled products, helping to ensure
patient safety.

Today, Mercy hospitals receive one shipment per day from the
Consolidated Services Center for all of their medication and medical
supplies—a significant improvement when considering that in the
past, each hospital could receive multiple shipments from multiple
vendors each day. "Since implementing Mercy Meds, we have
improved shipping accuracy by 50 percent and increased labor
productivity by 20 percent," says Black.

In the near future, Mercy plans to investigate the application
of the Mercy Meds model to its medical and surgical products. In the
meantime, the organization continues to focus on its mission of
delivering compassionate, high-quality clinical care. "It is
satisfying to know that Mercy is concerned enough about its
patients' safety to invest in initiatives such as Mercy Meds,"
says Kirster. "Ultimately, the program has enabled caregivers
to spend more time doing what they do best—taking care of patients."